• Chronic obstructive pulmonary disease (COPD)
Chronic obstructive pulmonary disease is a common condition
occurring in 17% of men and 8% of women between the ages of 45
and 64 years. It could perhaps more correctly be called “chronic
bronchitis and emphysema” because both conditions coexist in all
patients with COPD, to varying degrees. Virtually confined to
smokers, mortality from COPD is related to the number of
cigarettes smoked per day.
• Defining COPD
• COPD involves two diseases that are related;
bronchitis and emphysema. Both bronchitis and
emphysema involve a chronic obstruction of
airflow out of a person's lungs which is
commonly both permanent and progressive over
time. Asthma; another pulmonary disease
involving obstruction of airflow out of the lungs,
is unlike chronic bronchitis or emphysema in that
asthma is commonly reversible. Airflow between
asthma attacks is usually good.
• Causes of COPD
• The main cause of COPD in America is smoking;
approximately ninety-percent of persons with
COPD have it because of smoking. While not all
people who smoke go on to develop COPD, it is
estimated that approximately fifteen-percent of
smokers will. People who smoke and have COPD
experience higher death rates that nonsmokers
who have COPD, as well as experiencing more
frequent symptoms such as shortness of breath,
coughing, and lung deterioration. The effects of
second-hand exposure to tobacco smoke are not
well-known, although there is evidence
suggesting that asthma, and respiratory
infections are more common among children
and others who do not smoke in households
where there is a smoker present.
What is Asthma?
Simply put, asthma narrows the tubes present in the lungs during an acute
attack, which makes it more difficult for the sufferer to breathe.
Three factors affect this spasmodic reaction in the lungs' tubes. In addition,
because sufferers are struggling to breathe, muscles in the throat also
contract during an attack, and edema may also occur (basically, swelling),
which makes it even more difficult to breathe. Mucus may also build up
because mucus occurs as a reaction to irritants and tries to act as a buffer
or coating to both remove any irritant and to soothe the underlying tissue.
This constitutes an asthma attack.
Asthma attacks be relatively benign or very severe. Simply relaxing and breathing
through an attack calmly may be enough to thwart it, perhaps with use of an inhaler.
Experienced asthma sufferers know that it helps to be calm during an attack, in
order to make symptoms less severe and go away more quickly. Inexperienced
sufferers, or those prone to nervousness anyway, may experience panic attacks,
which would make the asthma attacks even more severe. The harder you try to
breathe, the harder it becomes. You may truly feel as though you are drowning.
• Reason 1 - Allergic Rhinitis
• The cause of asthma is also
known as a trigger and one
trigger is rhinitis. Allergic rhinitis
is excessive discharge of mucus
glands in the nose, congestion of
the veins in the nasal cavity that
can cause blockage of nasal
airflow and cause irritation of the
sensory nerves in the nose and
• Reason 2 - Heredity Cause
• Heredity is a big cause of asthma
in children. The tendency to
become allergic is inherited and is
controlled by genes that only
influence the production of an
antibody called IgE. However, you
will only develop an allergic
inherited allergy if exposed to
those certain inherited genes, if
you are never exposed you will
never develop a cause of asthma.
Common Ailments of the Respiratory
• The respiratory system if not well taken cared of will develop some
respiratory ailments. These ailments are:
• 1. Nosebleeding is also called epixtaxis. This may happen due to
• a. Picking the mucous
• b. Breathing very dry air
• c. Common colds
• d. High blood pressure
• When nosebleeding occurs, the best thing to do is sit up and lean
forward rather than lie down. This will help lower your blood pressure
and allow the blood to flow out of your nose rather than your throat.
• What to learn
• Diagnostic definitions – clinical history for bronchitis and
pathological for emphysema.
• Symptoms and signs, and the two subtypes of patient: pink puffers
and blue bloaters.
• Management of acute exacerbations and long-term prophylaxis.
• Interpretation of arterial blood gas results.
Asthma is a common chronic
inflammatory condition of the
airways that causes reversible
obstruction. The airways are
hyperresponsive to a wide range
of stimuli. Edema, smooth muscle
hypertrophy, and mucous
plugging cause obstruction.
• What to learn
• Classification into extrinsic and intrinsic
asthma, and the triggering,
exacerbating and relieving factors
• Structural changes that occur in the
airway, and their clinical features
• Emergency management of acute
• Medical management of chronic
asthma and inhaler technique
• Lung cancer
Bronchogenic carcinoma is the
most common cause of death
from cancer in the UK, affecting
30,000 people per year. Males are • What to learn
affected more often than
• The four main histological types:
females, but an increasing
squamous cell (50%), small cell
incidence is occurring in women.
(20%), adenocarcinoma (20%) and
Peak incidence is between 40 and large cell anaplastic (10%).
70 years of age. The UK has the
highest incidence of this disease • Risk factors, clinical features and
prognosis for each type.
in the world.
• Symptoms and signs of pulmonary
spread, metastatic spread, and
endocrine and neurological
• Management and palliation.
Pneumonia is defined as the
consolidation of lung tissue
caused by formation of intraalveolar inflammatory exudates
as a result of a lung infection. This
must be visible on X-ray to be
properly called pneumonia, as
opposed to ‘chest infection’.
Pneumonia is the fifth most
common cause of death,
according to US data.
• What to learn
• Predisposing factors to chest infection and
• Common causative organisms and the
distinction between community-acquired
and hospital-acquired pneumonia.
• Diagnostic and pathological features of
bronchopneumonia, lobar pneumonia and
• The special features of pneumonia in
• Appropriate antibiotic use for the various
types of pneumonia.
• Pulmonary tuberculosis (TB)
This is a chronic granulomatous
infection of the lung caused by
Mycobacterium tuberculosis. It is
uncommon in the UK, with an
incidence of 7 per 100,000 per year,
but is extremely common
worldwide. Pulmonary TB is a very
common exam topic because of the
increasing incidence in elderly,
homeless people, and the
emergence of drug-resistant strains.
• What to learn
• Risk factors for infection and routes by
which the organism can be spread.
• Pathogenesis: primary and secondary TB;
the histopathological sequence of events
that leads to granuloma formation.
• Symptom, signs and diagnosis of TB.
• Nonpulmonary TB.
• Drug treatments for TB, public health
measures to prevent spread and the
problems of ensuring compliance with
• Cystic fibrosis
Cystic fibrosis is a hereditary disease
characterized by the production of
abnormally thick mucus due to the
presence of an abnormal
transmembrane chloride ion
transporter. It primarily affects the
lung and pancreas. It is the most
common autosomal recessive
disorder, affecting 1 in 2000
newborns. Cystic fibrosis is a
common exam topic.
• What to learn
• Pathogenesis: learn the genetic and
molecular mechanisms and the
physiological effects that produce
the clinical features of the disease.
• Symptoms, signs and methods of
• Prognosis and management of the
pulmonary and pancreatic effects of
• Diffuse interstitial diseases
These diseases comprise a
group of noninfectious,
nonmalignant disorders in
which there is inflammation of
the alveolar walls with a
thickening of the interstitium
between the alveoli, usually
with fibrosis. Learning about
the features of the general
disease process and one or two
of the conditions in more detail
What to learn
• Histopathological changes for this
general group of diseases, and
management, which is similar for all
• Symptoms, signs and diagnostic
features of interstitial diseases.
• The three main causes of chronic
pulmonary fibrosis: (1) idiopathic
(sarcoidosis and cryptogenic
fibrosing alveolitis); (2) dust
inhalation, which might be inorganic
(coal workers’ pneumoconiosis) or
organic (farmers’ lung); and (3)
iatrogenic (radiation pneumonitis or
drug-induced by amiodarone or
Pneumothorax is the presence
of air in the pleural cavity. It is
common and can be
spontaneous or caused by
trauma. The severity can range
from mild to life threatening.
• What to learn
• Causes of pneumothorax:
spontaneous (idiopathic or
secondary to underlying
disease) and traumatic
(accidental or iatrogenic).
• Diagnosis and assessment of
• Management and risks of
• Reason 3 - Bronchial Irritability
• Bronchial irritability is the basic
cause of asthma problems. The
inflammation of the bronchial
walls causes loss of protective
cells from mucosa therefore
exposing sensitive nerve endings
to the affected area. This is
probably a direct result of
• Other Causes
• Besides the top 3 reasons, there
still other thing we should know
that bring on an asthma attack.
Dogs and cats cause asthma
attacks in some people. Tobacco
smoke, cold air, exercises and
even laughing can cause attacks.
• Exposure to certain things in your
work environment is another
cause of asthma in adults who
never suffered a day in their life
from asthma suddenly develops
• Chronic Obstructive Pulmonary Disease (COPD) - Irritation of the
lungs can lead to asthma, emphysema, and chronic bronchitis and
people can develop two or three of these together.
• Chronic Bronchitis - Any irritant reaching the bronchi and
bronchioles will stimulate an increased secretion of mucus. In
chronic bronchitis the air passages become clogged with mucus,
and this leads to a persistent cough.
• Emphysema - The delicate walls of the alveoli break down,
reducing the gas exchange area of the lungs. The condition
develops slowly and is seldom a direct cause of death.
• Asthma - Periodic constriction of the bronchi and bronchioles
makes it more difficult to breathe.
• Pneumonia - An infection of the alveoli. It can be caused by many
kinds of both bacteria and viruses. Tissue fluids accumulate in the
alveoli reducing the surface area exposed to air. If enough alveoli
are affected, the patient may need supplemental oxygen.
• Disorders of the respiratory system are usually treated internally by
a pulmonologist or respiratory physician.
• Asthma Allergies Bronchial
• Pneumonia is an
inflammatory illness of the
lung(s). Pneumonia can result
from a variety of causes,
including infection with
bacteria, viruses, fungi, or
parasites, and chemical or
physical injury to the lungs.
Prior to the discovery of
antibiotics, one-third of all
people who developed
pneumonia subsequently died
from the infection,
• Symptoms associated with
pneumonia include cough,
chest pain, fever, and difficulty
in breathing. Diagnostic tools
include x-rays and examination
of the sputum. Treatment
depends on the cause of
pneumonia is treated with